Korean J Pediatr.  2014 May;57(5):226-231. 10.3345/kjp.2014.57.5.226.

Kikuchi-Fujimoto disease mimicking malignant lymphoma with 2-[18F]fluoro-2-deoxy-D-glucose PET/CT in children

• Kim JE
• Lee EK
• Lee JM
• Bae SH
• Choi KH
• Lee YH
• Hah JO
• Choi JH
• Kong EJ
• Cho IH

• KMID: 2284121
• DOI: http://doi.org/10.3345/kjp.2014.57.5.226

Abstract

PURPOSE
Kikuchi-Fujimoto disease (KFD) is a benign disease, which is characterized by a cervical lymphadenopathy with fever, and it often mimics malignant lymphoma (ML). 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a powerful imaging modality for the diagnosis, staging and monitoring of ML, with the limitations including the nonspecific FDG uptake in infectious or inflammatory processes. This study compared clinical manifestations and PET/CT findings between KFD and ML patients.
METHODS
We retrospectively reviewed the medical records of 23 patients with KFD and 33 patients with ML, diagnosed histopathologically, between January 2000 and May 2013 at the Department of Pediatrics, Yeungnam University Medical Center. Among them, we analyzed the clinical manifestations, laboratory findings and characteristics, and the amount of 18F-FDG uptake between 8 KFD and 9 ML patients who had 18F-FDG PET/CT.
RESULTS
The 18F-FDG PET/CT maximum standardized uptake values (SUVmax) ranged from 8.3 to 22.5 (mean, 12.0) in KFDs, and from 5.8 to 34.3 (mean, 15.9) in MLs. There were no significant differences in SUVmax between KFDs and MLs. 18F-FDG PET/CT with ML patients showed hot uptakes in the extranodal organs, such as bone marrow, small bowel, thymus, kidney, orbit and pleura. However, none of the KFD cases showed extranodal uptake (P<0.001). 18F-FDG PET/CT findings of KFD with nodal involvement only were indistinguishable from those of ML.
CONCLUSION
Patients who had extranodal involvement on PET/CT were more likely to have malignancy than KFD.

Keyword

Kikuchi-Fujimoto disease; Lymphoma; Positron emission tomography

MeSH Terms

Academic Medical Centers
Bone Marrow
Child*
Diagnosis
Electrons
Fever
Fluorodeoxyglucose F18
Histiocytic Necrotizing Lymphadenitis*
Humans
Kidney
Lymphatic Diseases
Lymphoma*
Medical Records
Orbit
Pediatrics
Pleura
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Retrospective Studies
Thymus Gland
Fluorodeoxyglucose F18